Abstract

Village doctors (VD) are an integral source of healthcare in the rural areas. The VDs are mainly unregulated, less than fully qualified non-physician practitioners and vendors of modern (allopathic) medicine who provide a significant proportion of health care. It was evident from a recent study in Chakaria, a rural area in Bangladesh, that the VDs were providing care of questionable quality with considerable over prescription of drugs and the choice of drugs used for treatment were mostly inappropriate and at times harmful. To reduce the harmful practices of the VDs, an intervention was undertaken to improve the knowledge and skills of the unqualified providers through training; and to increase accountability of the VDs in the community, the local government and leaders were involved in monitoring the healthcare related activities of the providers. In addition, a network of the village doctors named as Shayshta Shenas was established to ensure strict adherence to treatment guidelines provided. Training in treatment guidelines for relevant common illnesses was provided to 125 out of 135 eligible village doctors in the intervention area. To assess the usefulness, relevance and the issues related to the intervention i.e. the training sessions, in-depth interviews and Focus Group Discussions (FGDs) were carried out with the village doctors, villagers and the members of the local union level committee. The feedback from the interviews/discussions with the different stakeholders provides important insights on the reasons for poor adherence to treatment guidelines offered and ways to improve the training intervention and health care practices of the VDs.